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I completed my anesthesiology training less than 18 months ago. During medical school, I had never heard the term “perioperative” and was introduced to this concept late in residency. I have learned that this concept essentially gives the anesthesiologist pre/intra/post-operative responsibility for the surgical patient. Pretty important, really.

Like all new professionals, I am paying my dues as a rookie, but also trying to keep an eye on the future. My conversations with colleagues, both young and experienced, tend to highlight a deep sense of uncertainty about what is coming. There is a lot of grumbling rhetoric with no clear consensus or alternatives, and a palpable anxiety about the future model(s) of anesthesiology. Very few of my colleagues have ever actually practiced with a perioperative tilt, and even fewer are open to the idea of more work with no known reimbursement guidelines. Aside from general concerns about major changes regarding finance and operations, I think we need to ask ourselves the following questions. Does perioperative medicine work? Will it improve patient outcomes? Will it strengthen our position in the marketplace and establish anesthesiologists as irreplaceable physician leaders? The data are scarce, but can we afford to do nothing in these times of rethinking and restructuring?